Comparison of quantiferon-TB gold with tuberculin skin test for detecting latent tuberculosis infection prior to liver transplantation

Am J Transplant. 2007 Dec;7(12):2797-801. doi: 10.1111/j.1600-6143.2007.02011.x. Epub 2007 Oct 17.

Abstract

Screening for latent tuberculosis infection (LTBI) is recommended prior to organ transplantation. The Quantiferon-TB Gold assay (QFT-G) may be more accurate than the tuberculin skin test (TST) in the detection of LTBI. We prospectively compared the results of QFT-G to TST in patients with chronic liver disease awaiting transplantation. Patients were screened for LTBI with both the QFT-G test and a TST. Concordance between test results and predictors of a discordant result were determined. Of the 153 evaluable patients, 37 (24.2%) had a positive TST and 34 (22.2%) had a positive QFT-G. Overall agreement between tests was 85.1% (kappa= 0.60, p < 0.0001). Discordant test results were seen in 12 TST positive/QFT-G negative patients and in 9 TST negative/QFT-G positive patients. Prior BCG vaccination was not associated with discordant test results. Twelve patients (7.8%), all with a negative TST, had an indeterminate result of the QFT-G and this was more likely in patients with a low lymphocyte count (p = 0.01) and a high MELD score (p = 0.001). In patients awaiting liver transplantation, both the TST and QFT-G were comparable for the diagnosis of LTBI with reasonable concordance between tests. Indeterminate QFT-G result was more likely in those with more advanced liver disease.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • BCG Vaccine
  • Female
  • Gold*
  • Humans
  • Interferon-gamma / metabolism*
  • Liver / microbiology
  • Liver / pathology
  • Liver Diseases / metabolism
  • Liver Diseases / surgery
  • Liver Transplantation*
  • Lymphocytes / metabolism
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / metabolism
  • Prospective Studies
  • Sensitivity and Specificity
  • Tuberculin Test / methods*
  • Tuberculin Test / standards
  • Tuberculosis / diagnosis*
  • Tuberculosis / metabolism

Substances

  • BCG Vaccine
  • Gold
  • Interferon-gamma